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Scan Lab
The Market
Sc an Lab will target insurance carriers. Insurance carriers use a bid submittal proc ess to set up
contrac ts with the various medical sc an service providers. In today's medical environment
these contac t are key bec ause 99% of the sc ans done are billed through insurance. Insurance
companies therefore are the gate keepers to this proc ess. Sc an Lab recognizes the importance
of getting insurance carriers approval and will work hard to get approved by all popular insurance
plans.
Once Sc an Lab has been approved by an insurance company, it will rely on referrals of
physicians to point their patients to Sc an Lab. Doc tors make referrals based on several fac tors
including geographic loc ation/convenience who they know, ac cepted forms of insurance, type
of scan, etc. It will be important to have a strong marketing and sales campaign that alerts
referring doctors to Sc an Lab's services.
Services
Sc an Lab offers a wide range of radiology-based medical sc anning tests. Sc an Lab has the latest
equipment and the expert medical training to interpret and provide valuable consultations to
the physicians who make the patient referrals to Sc an Lab.
Management
Sc an Lab will be lead by Dr. Carolyn Jones. Dr. Jones received her medical degree with a
specialization in radiology from the University of California San Diego, a nationally recognized
medical school for radiology. Dr. Jones performed her residency at John Hopkins, also nationally
recognized for their radiology program. Dr. Jones has prac ticed radiology for 13 years at a large
clinic in Boston.
1.1 Mission
It is Sc an Lab's mission to be recognized as the leader in medical sc anning technology in New
Bedford. This will be ac hieved by friendly service, flexible ac ceptance of insurance plans, and
ac curate analysis.
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1.2 Objectives
· To capture 40% of loc al physicians' business within two years.
· To reac h profitability within two years.
· To double sales by year three.
· Office furniture for four exam rooms. This equipment will be purchased used in good
condition. This will be done as a cost saving measure.
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· Receptionist office furniture and assorted waiting room furniture (this will also be
purchased in good, used condition).
· Three computers, one with QuickBooks Pro, all with Microsoft Office, a central laser
printer and broadband Internet connection.
· Medical scanning devices:
° X-ray mac hine
° Ultra sound unit
° CAT scan imaging mac hine
° MRI imaging mac hine
Table: Start-up
Start-up
Requirements
Start-up Expenses
Legal $3,000
Stationery etc. $300
Brochures $300
Consultants $2,000
Insurance $3,000
Rent $2,000
Total Start-up Expenses $10,600
Start-up Assets
Cash Required $317,900
Other Current Assets $0
Long-term Assets $861,500
Total Assets $1,179,400
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Assets
Non-cash Assets from Start-up $861,500
Cash Requirements from Start-up $317,900
Additional Cash Raised $0
Cash Balance on Starting Date $317,900
Total Assets $1,179,400
Liabilities
Current Borrowing $0
Long-term Liabilities $860,000
Accounts Payable (Outstanding Bills) $0
Other Current Liabilities (interest-free) $0
Total Liabilities $860,000
Capital
Planned Investment
Dr. Jones $180,000
Investor $150,000
Additional Investment Requirement $0
Total Planned Investment $330,000
3.0 Services
Sc an Lab offers New Bedford physicians a wide range of diagnostic scanning tests. Due to the
high cost of sc anning equipment for oc casional use, most small clinics and prac tices use an
outside service provider for scanning needs. The following scans will be offered:
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· Ultrasound: This technology sends sound waves into the body, recording the
reflection. Ultrasound is used for a detailed assessment of blood flow and for views of
soft tissue and anatomical body structure.
· CAT Scan: This is a diagnostic technology that uses a combination of x-rays and
computer technology to produce cross- sectional images ("slices") in a horizontal and
vertical orientation. A CAT sc an can show detailed images of any part of the body
including bones, muscles, fat, and organs. CAT scans are more detailed than traditional
x-rays and have lower releases of radiation. CAT sc ans are often used to diagnose
tumors, evaluate internal bleeding or investigate internal injuries or damage.
· MRI: This technology harnesses magnetic energy. The patient is plac ed in a tube or on
a bed where magnetic fields are applied to the body. The reac tion by the body when
the magnetic fields are applied and relaxed are noted by a computer which has been
recording data throughout the proc ess. MRIs are the premier scanning device for
extremities, espec ially joints, as well as for imaging the upper spine and lower bac k.
The second customer group is the physicians. While the insurance company will mandate what
labs are ac ceptable for their insurance plan, it is the doc tor's choice where they recommend
their patients goes.
Sc an Lab has been involved in negotiations with these three insurance carriers to develop an
arrangement for Sc an Lab to be an approved fac ility. The next step is the submission of a bid,
which is primarily based on price. The lab must agree to rates that the insurance companies
have set forth. A secondary consideration is the ability of the lab to adhere to spec ific filing
and billing proc edures.
The second target market segment is physicians. Physicians make referrals based on numerous
fac tors including:
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Scan Lab
· Convenience of loc ation relative to their office or to the patient's home.
Physicians direct the patient to where they must go for a sc an. Because Sc an Lab is loc ated
within a professional building with many doctors, this level of convenience with often prompt
the doctor to immediately recommend Sc an Lab.
Only large clinics and prac tices can justify buying their own scanning equipment. For a small
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Scan Lab
clinic or prac tice, the high equipment cost with low use rate makes cost per use expensive.
Sc an Lab's direct competitors offer their services to all physicians and ac cept a wide range of
insurance plans. These competitors rarely offer services beyond medical imagine test and
radiologist analysis. The medical sc anning industry can be profitable if there is not over
capacity of the scanning mac hines in the area. A profitable capacity is to have approximately
five MRIs for every 100,000 people. Currently, New Bedford, with a population of 300,000 has 12.
· Bedford Scanning: This is a small fac ility with one part time radiologist on staff. They
only have an MRI and CAT sc an, they do not offer any other types of imaging services.
· Radiologist Imaging: This fac ility is similar to Sc an Lab but is loc ated on the far side
of town, a 25 minute drive away, therefore this fac ility seems to serve a more regional
customer base due to their non-centralized loc ation.
Sc an Lab also has indirect competition from clinics and large prac tices with their own scanning
equipment. This group does not serve outside physicians so it is only a threat if they recruit
doctors, that use Sc an Lab, away from private prac tice.
There is not a significant amount of work that needs to oc cur to market to the insurance
companies. This ac tivity is handled by bid submission. Most ac tivities directed at the insurance
companies will oc cur through the sales campaign. Sc an Lab will also embark on a sales strategy
that has the goal of converting qualified doctors into referring doctors, Sc an Lab's source of
patients. The following three sections provides this analysis.
· Yellow Pages: While the Yellow Pages are not as targeted as other methods of
communication, these advertisements will be nec essary as many people turn to the pages
when they do not have a specific service provider in mind. The ads are proven to be cost
effective.
· Circulars: These will be pamphlets that are sent out to loc al physicians. The pamphlet
will serve to introduce Sc an Lab and detail the different services that it offers. It will also
provide information on Dr. Carolyn Jones and will include bac kground into her
professional ac complishments and ac tivities.
· Networking: Dr. Jones recognizes the importance of networking, getting to know the
physicians that work in New Bedford. A high percentage of referrals are made based on
personal and professional contac ts so networking is a very effective method of increasing
the number of referrals. Dr. Jones will be ac tive in the numerous organizations and
committees that are present within the medical community.
For patients the scanning must be convenient, pleasant, and ac cept most insurance plans. For
physicians, it must be a high-quality radiologist analysis. The better the analysis, the more
ac curate information that the radiologists can offer in the consultation to the referring physician.
Sc an Lab will be networking with various insurance carriers. The first step is to determine who
the key contac t at the insurance company is. These contac ts will be useful in providing
information on what is expec ted in the submitted bid.
The sales forecast is broken down by the type of service provided and displayed in the
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following table. The charts give a visual representation of monthly and yearly figures.
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5.4 Milestones
Sc an Lab has chosen several quantifiable milestones that have been developed as goals for
the organization to ac hieve. The following table details the specific milestones, the time frame
that has been estimated for completion of the milestone, and the specific employee responsible.
Table: Milestones
Milestones
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large clinic in Boston.
Dr. Jones has published 14 articles and is frequently asked to present her papers at conferences.
· Dr. Jones: In addition to being the resident radiologist, she will also be responsible for
business development, and some marketing and sales.
· Technicians: Four people will be responsible for the operation of the mac hines.
· Administration: Two people will be responsible for the clerical duties and bookkeeping.
Table: Personnel
Personnel Plan
Year 1 Year 2 Year 3
Dr. Jones $60,000 $61,800 $63,654
Technicians $48,000 $49,440 $50,923
Other $19,200 $19,776 $20,269
Total People 5 5 5
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point.
Assumptions:
Average Percent Variable Cost 23%
Estimated Monthly Fixed Cost $31,248
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Expenses
Payroll $127,200 $131,016 $134,846
Sales and Marketing and Other Expenses $6,000 $0 $0
Depreciation $172,300 $0 $0
Rent $24,000 $0 $0
Utilities $6,000 $0 $0
Insurance $18,000 $0 $0
Payroll Taxes $19,080 $0 $0
Other $2,400 $0 $0
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Scan Lab
Current Assets
Cash $188,525 $157,048 $162,841
Accounts Receivable $76,532 $80,184 $88,203
Other Current Assets $0 $0 $0
Total Current Assets $265,057 $237,232 $251,044
Long-term Assets
Long-term Assets $861,500 $861,500 $861,500
Accumulated Depreciation $172,300 $172,300 $172,300
Total Long-term Assets $689,200 $689,200 $689,200
Total Assets $954,257 $926,433 $940,244
Current Liabilities
Accounts Payable $24,132 $17,479 $17,965
Current Borrowing $0 $0 $0
Other Current Liabilities $0 $0 $0
Subtotal Current Liabilities $24,132 $17,479 $17,965
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Table: Ratios
Ratio Analysis
Year 1 Year 2 Year 3 Industry Profile
Sales Growth n.a. 4.77% 10.00% 8.83%
Percent of Sales
Sales 100.00% 100.00% 100.00% 100.00%
Gross Margin 77.00% 76.88% 78.34% 100.00%
Selling, General & Administrative Expenses 102.84% 0.00% 0.00% 66.55%
Advertising Expenses 0.00% 0.00% 0.00% 0.85%
Profit Before Interest and Taxes -11.79% 47.27% 50.63% 5.72%
Main Ratios
Current 10.98 13.57 13.97 1.77
Quick 10.98 13.57 13.97 1.49
Total Debt to Total Assets 80.08% 68.81% 55.09% 54.16%
Pre-tax Return on Net Worth -67.99% 48.86% 45.10% 6.71%
Pre-tax Return on Assets -13.55% 15.24% 20.26% 14.64%
Activity Ratios
Accounts Receivable Turnover 4.14 4.14 4.14 n.a
Collection Days 56 86 84 n.a
Accounts Payable Turnover 10.45 12.17 12.17 n.a
Payment Days 27 36 30 n.a
Total Asset Turnover 0.44 0.48 0.52 n.a
Debt Ratios
Debt to Net Worth 4.02 2.21 1.23 n.a
Current Liab. to Liab. 0.03 0.03 0.03 n.a
Liquidity Ratios
Net Working Capital $240,925 $219,754 $233,079 n.a
Interest Coverage -0.63 3.08 4.40 n.a
Additional Ratios
Assets to Sales 2.26 2.09 1.93 n.a
Current Debt/Total Assets 3% 2% 2% n.a
Acid Test 7.81 8.99 9.06 n.a
Sales/Net Worth 2.22 1.53 1.15 n.a
Dividend Payout 0.00 0.00 0.00 n.a
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Appendix
Table: Sales Forecast
Sales Forecast
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12
Sales
X-ray 0% $0 $0 $5,500 $8,565 $10,005 $12,454 $13,121 $14,005 $14,989 $15,114 $15,265 $15,274
Ultrasound 0% $0 $0 $3,245 $5,053 $5,903 $7,348 $7,741 $8,263 $8,844 $8,917 $9,006 $9,012
CAT scan 0% $0 $0 $6,050 $9,422 $11,006 $13,699 $14,433 $15,406 $16,488 $16,625 $16,792 $16,801
MRI 0% $0 $0 $3,894 $6,064 $7,084 $8,817 $9,290 $9,916 $10,612 $10,701 $10,808 $10,814
Total Sales $0 $0 $18,689 $29,104 $33,997 $42,319 $44,585 $47,589 $50,933 $51,357 $51,870 $51,901
Direct Cost of Sales Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12
X-ray $0 $0 $1,265 $1,970 $2,301 $2,864 $3,018 $3,221 $3,447 $3,476 $3,511 $3,513
Ultrasound $0 $0 $746 $1,162 $1,358 $1,690 $1,781 $1,900 $2,034 $2,051 $2,071 $2,073
CAT scan $0 $0 $1,392 $2,167 $2,531 $3,151 $3,320 $3,543 $3,792 $3,824 $3,862 $3,864
MRI $0 $0 $896 $1,395 $1,629 $2,028 $2,137 $2,281 $2,441 $2,461 $2,486 $2,487
Subtotal Direct Cost of Sales $0 $0 $4,298 $6,694 $7,819 $9,733 $10,255 $10,945 $11,715 $11,812 $11,930 $11,937
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Appendix
Table: Personnel
Personnel Plan
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12
Dr. Jones 0% $0 $0 $6,000 $6,000 $6,000 $6,000 $6,000 $6,000 $6,000 $6,000 $6,000 $6,000
Technicians 0% $0 $0 $0 $3,000 $3,000 $6,000 $6,000 $6,000 $6,000 $6,000 $6,000 $6,000
Other 0% $0 $0 $0 $1,200 $1,200 $2,400 $2,400 $2,400 $2,400 $2,400 $2,400 $2,400
Total People 0 0 0 3 3 5 5 5 5 5 5 5
Total Payroll $0 $0 $6,000 $10,200 $10,200 $14,400 $14,400 $14,400 $14,400 $14,400 $14,400 $14,400
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Appendix
Table: General Assumptions
General Assumptions
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12
Plan Month 1 2 3 4 5 6 7 8 9 10 11 12
Current Interest Rate 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00%
Long-term Interest Rate 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00%
Tax Rate 30.00% 30.00% 30.00% 30.00% 30.00% 30.00% 30.00% 30.00% 30.00% 30.00% 30.00% 30.00%
Other 0 0 0 0 0 0 0 0 0 0 0 0
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Appendix
Table: Profit and Loss
Gross Margin $0 $0 $14,391 $22,410 $26,178 $32,585 $34,331 $36,644 $39,218 $39,545 $39,940 $39,964
Gross Margin % 0.00% 0.00% 77.00% 77.00% 77.00% 77.00% 77.00% 77.00% 77.00% 77.00% 77.00% 77.00%
Expenses
Payroll $0 $0 $6,000 $10,200 $10,200 $14,400 $14,400 $14,400 $14,400 $14,400 $14,400 $14,400
Sales and Marketing and Other $500 $500 $500 $500 $500 $500 $500 $500 $500 $500 $500 $500
Expenses
Depreciation $14,358 $14,358 $14,358 $14,358 $14,358 $14,358 $14,358 $14,358 $14,358 $14,358 $14,358 $14,358
Rent $2,000 $2,000 $2,000 $2,000 $2,000 $2,000 $2,000 $2,000 $2,000 $2,000 $2,000 $2,000
Utilities $500 $500 $500 $500 $500 $500 $500 $500 $500 $500 $500 $500
Insurance $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500
Payroll Taxes 15% $0 $0 $900 $1,530 $1,530 $2,160 $2,160 $2,160 $2,160 $2,160 $2,160 $2,160
Other $200 $200 $200 $200 $200 $200 $200 $200 $200 $200 $200 $200
Total Operating Expenses $19,058 $19,058 $25,958 $30,788 $30,788 $35,618 $35,618 $35,618 $35,618 $35,618 $35,618 $35,618
Profit Before Interest and Taxes ($19,058) ($19,058) ($11,568) ($8,378) ($4,611) ($3,033) ($1,288) $1,025 $3,600 $3,927 $4,322 $4,346
EBITDA ($4,700) ($4,700) $2,791 $5,980 $9,748 $11,325 $13,071 $15,384 $17,958 $18,285 $18,680 $18,704
Interest Expense $7,083 $7,000 $6,917 $6,833 $6,750 $6,667 $6,583 $6,500 $6,417 $6,333 $6,250 $6,167
Taxes Incurred $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Net Profit ($26,142) ($26,058) ($18,484) ($15,212) ($11,361) ($9,700) ($7,871) ($5,475) ($2,817) ($2,406) ($1,928) ($1,821)
Net Profit/Sales 0.00% 0.00% -98.91% -52.27% -33.42% -22.92% -17.65% -11.50% -5.53% -4.69% -3.72% -3.51%
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Appendix
Table: Cash Flow
Expenditures Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12
Net Cash Flow ($10,393) ($21,781) ($23,198) ($29,370) ($17,216) ($12,751) ($10,822) ($4,425) ($2,481) ($777) $1,771 $2,068
Cash Balance $307,507 $285,727 $262,528 $233,158 $215,943 $203,191 $192,369 $187,944 $185,462 $184,685 $186,456 $188,525
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Appendix
Table: Balance Sheet
Current Assets
Cash $317,900 $307,507 $285,727 $262,528 $233,158 $215,943 $203,191 $192,369 $187,944 $185,462 $184,685 $186,456 $188,525
Accounts Receivable $0 $0 $0 $14,017 $35,377 $46,598 $56,387 $64,120 $68,016 $72,701 $75,444 $76,137 $76,532
Other Current Assets $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Total Current Assets $317,900 $307,507 $285,727 $276,545 $268,536 $262,541 $259,578 $256,489 $255,960 $258,164 $260,130 $262,593 $265,057
Long-term Assets
Long-term Assets $861,500 $861,500 $861,500 $861,500 $861,500 $861,500 $861,500 $861,500 $861,500 $861,500 $861,500 $861,500 $861,500
Accumulated Depreciation $0 $14,358 $28,717 $43,075 $57,433 $71,792 $86,150 $100,508 $114,866 $129,225 $143,583 $157,941 $172,300
Total Long-term Assets $861,500 $847,142 $832,783 $818,425 $804,067 $789,709 $775,350 $760,992 $746,634 $732,275 $717,917 $703,559 $689,200
Total Assets $1,179,400 $1,154,649 $1,118,510 $1,094,970 $1,072,603 $1,052,249 $1,034,928 $1,017,481 $1,002,593 $990,439 $978,047 $966,152 $954,257
Liabilities and Capital Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12
Current Liabilities
Accounts Payable $0 $11,391 $11,310 $16,255 $19,099 $20,106 $22,485 $22,908 $23,495 $24,158 $24,172 $24,206 $24,132
Current Borrowing $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Other Current Liabilities $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Subtotal Current Liabilities $0 $11,391 $11,310 $16,255 $19,099 $20,106 $22,485 $22,908 $23,495 $24,158 $24,172 $24,206 $24,132
Long-term Liabilities $860,000 $850,000 $840,000 $830,000 $820,000 $810,000 $800,000 $790,000 $780,000 $770,000 $760,000 $750,000 $740,000
Total Liabilities $860,000 $861,391 $851,310 $846,255 $839,099 $830,106 $822,485 $812,908 $803,495 $794,158 $784,172 $774,206 $764,132
Paid-in Capital $330,000 $330,000 $330,000 $330,000 $330,000 $330,000 $330,000 $330,000 $330,000 $330,000 $330,000 $330,000 $330,000
Retained Earnings ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600) ($10,600)
Earnings $0 ($26,142) ($52,200) ($70,684) ($85,896) ($97,257) ($106,956) ($114,827) ($120,302) ($123,119) ($125,525) ($127,453) ($129,275)
Total Capital $319,400 $293,258 $267,200 $248,716 $233,504 $222,143 $212,444 $204,573 $199,098 $196,281 $193,875 $191,947 $190,125
Total Liabilities and Capital $1,179,400 $1,154,649 $1,118,510 $1,094,970 $1,072,603 $1,052,249 $1,034,928 $1,017,481 $1,002,593 $990,439 $978,047 $966,152 $954,257
Net Worth $319,400 $293,258 $267,200 $248,716 $233,504 $222,143 $212,444 $204,573 $199,098 $196,281 $193,875 $191,947 $190,125
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